Stepping Up to the Challenge

Even though I have enjoyed all of my past rotations during the third year thus far, I have not truly looked forward to any rotation with much anticipation with the exception of Internal Medicine which began today. In addition to my excitement and apprehension over having greater degrees of independence and responsibility in the realms of patient care and clinical reasoning, I am furthermore interested to see what challenge Internal Medicine poses to Interventional Neurology/Vascular Neurology along my future career path. If anything stands a chance, it is Internal Medicine and its subspecialties.

Already, I feel a mild culture shock (or perhaps simply the shock of jet lag and rousing oneself intellectually from two weeks of academic hibernation). Today my (awesome) teammates and I rounded with our new service, a general Internal Medicine service overseeing the care of almost a score of patients. The severity of the illnesses of the patients is remarkable: rather, it is slightly disorienting returning to the world of sick patients after spending eight weeks on my Obstetrics & Gynecology clerkship with mostly healthy patients. However, I am hoping that it will gradually feel like home again: liking patients for their shows of strength and gratitude rather than their “good” day personalities, wrapping my head around some deeper medical mysteries rather than uncovering the reasons behind relatively simple discomforts, and being more attuned to the suffering of my patients rather than being obligated to say, “Sorry to tell you, but that’s normal.”

As much as I’d like to resist the temptation, I have pulled out my black bag again to carry with me on the wards: I do not think that my few pockets and belt holsters will be enough to properly equip me to best serve the very sick. Then again, perhaps the most important tools I need to remember to bring with me are the ones implied in the expectations given to us by our Clerkship Director: the right priorities, the right approach, and the right attitude.

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